手术后复发性静脉曲张的病因及模式评估。
Assessment of causes and patterns of recurrent varicose veins after surgery.
作者信息
Gad Mohammed A, Saber Aly, Hokkam Emad N
机构信息
Department of General Surgery, Suez Canal University, Egypt.
出版信息
N Am J Med Sci. 2012 Jan;4(1):45-8. doi: 10.4103/1947-2714.92905.
BACKGROUND
Varicose vein surgery is characterized by high recurrence rate of 60% after 5 years of follow-up observation, and this is a disappointing finding, both for the patient and surgeon.
AIM
To identify the possible causes and patterns of recurrent varicose veins.
MATERIALS AND METHODS
92 patients with recurrent varicose veins were enrolled in this study. Full detailed history, examination, and investigations were done.
RESULTS
30 patients had recurrence after saphenofemoral disconnection, 22 patients with recurrence after saphenofemoral disconnection and stripping below knee, 28 patients recurrence after saphenofemoral disconnection with stripping above knee and 12 patients recurrence after sapheno-popliteal disconnection with stripping. The double great saphenous veins, neovascularization and deep venous thrombosis before and after surgery were the most observed patterns of recurrence. The anatomical patterns of recurrence were more in leg then both leg and thigh pattern.
CONCLUSION
Saphenofemoral ligation with below knee stripping has the least frequency of recurrence, while Trendlenberg operation alone has the highest.
背景
大隐静脉曲张手术后经5年随访观察发现复发率高达60%，这一结果令患者和外科医生都感到失望。
目的
确定复发性大隐静脉曲张的可能原因和模式。
材料与方法
本研究纳入92例复发性大隐静脉曲张患者。详细询问病史、进行体格检查及相关检查。
结果
30例患者在大隐静脉高位结扎术后复发，22例在大隐静脉高位结扎及膝下剥脱术后复发，28例在大隐静脉高位结扎及膝上剥脱术后复发，12例在大隐静脉-腘静脉结扎及剥脱术后复发。最常见的复发模式为双大隐静脉、新生血管形成以及手术前后的深静脉血栓形成。复发的解剖模式以单纯小腿部复发多于小腿及大腿部同时复发。
结论
大隐静脉高位结扎并膝下剥脱术的复发率最低，而单纯大隐静脉高位结扎术的复发率最高。
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